Introduction Sodium nitrite and sodium nitrate have emerged as public health concerns due to their association with severe poisoning and intentional self-harm. As social media increasingly shapes how adolescents and young adults access and share information, platforms such as TikTok may facilitate prevention while also increasing exposure to potentially harmful narratives. This study aimed to investigate sodium nitrite/nitrate-related content on TikTok, focusing on harm-related discourse, suicide-related framing, engagement patterns, and automated harmful-content detection. Methods We analyzed metadata from the most-viewed TikTok videos discussing sodium nitrite using discourse analysis, BERTopic, HarmNER, BART-MNLI, DistilBERT, and supervised machine-learning models, including logistic regression and XGBoost, with SHAP-based explainability. Results Harm, misuse, overdose, and suicide were prominent themes. Engagement was highly skewed, with a small number of posts receiving disproportionate visibility. Prevention-oriented content was more common than explicitly harmful content, but harmful narratives remained present. Logistic regression showed the best performance for harmful-content detection. Conclusion TikTok contains both preventive and potentially harmful narratives related to sodium nitrite/nitrate, underscoring the platform’s dual role in self-harm communication. These findings highlight the value of explainable machine-learning approaches for the early identification of high-risk content and for strengthening moderation, suicide prevention, and digital public health responses.
Objectives About 275 million people worldwide use psychoactive substances with alcohol and tobacco being some of the most commonly abused. This study investigated the prevalence, sociodemographic correlates, and sexual health associations of distinct alcohol and tobacco use categories among men in Ghana. Methods This study utilised a cross-sectional study design, relying on the 2022 Ghana Demographic and Health Survey dataset, which consisted of history of alcohol and tobacco use, and background characteristics of 7,044 men. Chi-square, binary and multinomial logistic regression analyses were used to assess associations. Results This study found 34.1% of males used alcohol and tobacco in varying categories. Prevalence of sole alcohol and tobacco use, and dual use were 28.5%, 2.5%, and 3.1%, respectively. Age (p < 0.001), educational level (p < 0.001), wealth (p = 0.006), marital status (p < 0.001), and employment (p = 0.002) were significantly associated categories of alcohol and tobacco use. Compared with abstinence, dual use was associated with higher odds of extra-spousal partnership (AOR = 3.534; 95% CI = 2.366, 5.278), and history of STI (AOR = 2.422; 95% CI = 1.463, 4.011), genital sore/ulcer (AOR = 2.114; 95% CI = 1.233, 3.626) and genital discharge (AOR = 2.116; 95% CI = 1.209, 3.705). Conclusions Prevalence of alcohol and/or tobacco use among men in Ghana was 34.1%. Dual use was found to be associated with extra-spousal partnership and adverse sexual health outcomes. It is recommended that risk-reducing policies targeting middle-aged and older men be implemented in order to limit substance use.
